Comparison of the Neurocompatibility of 3 Different Classes of Endodontic Materials, Resin-Based (AH-Plus), Calcium Silicate (BC-Sealer), and Hydrogel-Based (OdneTMFill).

Introduction: Endodontic therapy is generally effective at relieving pain in patients experiencing acute odontogenic pain, but a small percentage of patients can experience long lasting postoperative pain. Postoperative pain could result from a variety of factors including toxicity of the chemical factors and the amount and type of tissue damage. Since dental sealers can come into contact with periapical tissue including nerve endings and potentially induce nerve injury and inflammatory pain, this study aims to compare the neurocompatibility of three distinct classes of endodontic material, resin-based sealer (AH-Plus), calcium silicate-based sealer (BC-Sealer) and a new class endodontic root canal filling material that is hydrogel-based (OdneFill in both solid and liquid forms).

Methods: In-vitro models of human and mouse sensory neurons. Cell viability was determined using a live/dead cell assay and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Neurite growth was measured to study neuronal health and function, and neurotoxicity gene marker expression was measured by quantitative polymerase chain reaction.

Results: We show that each material induces a different level of neuronal toxicity, with AH + sealer being the least compatible, BC-sealer and liquid OdneFill having intermediate compatibility and the solid OdneFill being the most compatible.

Conclusion: This study provides new insight into the relationship between endodontic materials and neuronal injury, adding to clinicians' understanding of the neurotoxic effects of sealers. This might assist in their material selection to minimize nerve injury following root canal therapy. Within the limitations of this study, we found that OdneFill and BC-sealer exhibited the most neurocompatibility, while AH + had the least neurocompatibility.